A major hospital trust at the centre of a police investigation allowed significant numbers of unregistered consultants to operate on patients, it has been claimed.
At least 105 cases of medical negligence and allegations of a cover-up at Royal Sussex University Hospitals NHS Foundation Trust are currently being probed.
The Telegraph has learnt that, as part of the investigation, officers are considering allegations that numerous surgeons in the troubled general surgery department in Brighton held the title of consultant without having qualified for the specialist register.
It can also be revealed that a weekly clinical safety meeting was scrapped in favour of a monthly meeting shortly before the period that saw many of the mishaps currently under review.
In order to qualify for the register, aspiring senior doctors must undergo a lengthy training under different mentors and pass multiple specialist exams.
Under NHS rules, only those who are on the register may take up any fixed-term, honorary or substantive consultant post in the NHS, subject to a few exceptions.
However, foundation trusts are not bound by this rule, in recognition of their greater legal autonomy compared to traditional hospitals.
Sources have claimed that, at its worst point, the proportion of unregistered consultant surgeons at the Royal Sussex County Hospital exceeded 40 per cent, although the trust is understood to dispute this figure.
National shortage
There is currently a national shortage of consultants and concerns have begun to emerge from the medical establishment in recent years about a growing use of non-registered consultants to deal with rising patient demand.
A spokesman for the trust said: “Appointing experienced doctors not on the specialist register to consultant positions is common practice in the NHS, provided they can demonstrate the required training and expertise in their field.”
However, a source told The Telegraph: “The Royal Sussex County Hospital is a major trauma centre and supposed to be a teaching hospital.
“To claim it’s acceptable to have a high number of unregistered surgeons at a centre like this is entirely wrong and dangerous.”
A recently published review by the Royal College of Surgeons criticised “bullying” and a “culture of fear” at the trust.
Meanwhile, a damning Care Quality Commission report found a “wide disconnect in the relationship between staff and senior leaders”.
Governance drastically reduced
The Telegraph can disclose that in 2019 there was a major shake-up of clinical governance in general surgery which drastically reduced the frequency of morbidity and mortality meetings, where deaths and complications were discussed in order to learn lessons.
For several years up until that point, the reviews had taken place weekly on a Friday afternoon.
However, at a meeting of the department in the summer of 2019, new leadership scrapped the weekly meetings, with staff allegedly told their time could be put to better use.
The trust said the meetings became monthly, and that this was in line with Royal College of Surgeons guidelines.
The guidelines state that: “A frequency of one meeting each month is the most common arrangement.”
However, the guidelines add: “In large, busy units and for specialties in which complications are more prevalent it may be appropriate to meet more than once a month.”
Mr Peter Duffy, a consultant neurosurgeon who is now campaigning for better protection for whistleblowers in the NHS, said the decision to reduce the frequency of morbidity and mortality meetings “rings serious alarm bells”.
“If senior clinicians came to the conclusion that they needed weekly meetings and they were overruled, that raises serious alarm bells.
“At best it suggests a dysfunctional relationship there. Without these meetings, deaths can sometimes be brushed under the carpet.
“There are a range of clinical governance benefits.”
It is understood that at the 2019 meeting senior surgeons were also told that their offices would be moved away from the main department, a significant walk away.
Dr George Findlay, the trust chief executive, has promised improvements in the wake of the CQC report.
He previously served as deputy under Dame Mariane Griffiths, a close ally of former health secretary Jeremy Hunt, who retired in 2022.
At least two Employment Tribunals of former senior doctors at the trust are expected to go ahead in the coming weeks.
A spokesman said: “In 2019, a new Surgery leadership team changed case reviews to monthly which is in line with the Royal College of Surgeons guidance on frequency of M&M meetings.”
He added: “All surgeons employed by the Trust are licensed to practise by the General Medical Council.”
